Text

theses

Purpose of Project: The purpose of this quality improvement pilot project was to introduce healthcare transition (HCT) and readiness assessment in a robust pediatric gastroenterology practice housed in a large pediatric subspecialty center and establish and assess workflow for standardized routine healthcare transition (HCT) readiness using the Transition Readiness Assessment Questionnaire 5.0 (TRAQ/TRAQ-C). Furthermore, the project was designed to assess screening results to make specialty-, diagnosis-, and/or Center-specific screening recommendations using the findings to establish a plan for sustainability within the department and expand screening to the larger subspecialty center. Methodology: This project used a convenience sample of patients and their parents/caregivers to implement the TRAQ/TRAQ-C, who presented for a return medical visit to pediatric gastroenterology over a one-month time frame. Results: Overall, the workflow was effective. However, collectively the project was labor-intensive and modifications will need to be made to ensure sustainability. There was a TRAQ return rate of 84% however, provider review of the tool fell short at 21.4%. Patients who presented to the visit without a parent scored higher overall on the TRAQ than their counterparts who came with a parent. In addition, the TRAQ-C scores of parent’s perceptions of readiness were significantly higher overall (p < 0.01) than the TRAQ scores of the patients' assessment of readiness. Implications for Practice: Barriers to implementation with provider review exist within this system that includes knowledge of HCT, provider perception of HCT, and perceived time for clinicians to review the completed assessment tool within the allotted timeframe for follow up visits. Additionally, patients demonstrated a deficiency in self-management skills needed for the transition to adult healthcare as measured by the TRAQ tool. Recommendations for sustainability and future projects include: (a) more robust education regarding HCT for Center providers, parent/caregivers, and staff, (b) introduction of the tool with minor revisions to workflow within motivated Center subspecialties, (c) addition of a HCT facilitator to the Center, and (d) integration of a HCT to the electronic medical record for ongoing HCT surveillance and billing.

ETD_10958

DNP

Includes bibliographical references

doi:10.7282/t3-d5ec-tt10

ETD doctoral

The author owns the copyright to this work.